颞颌关节强直课件.ppt

Distraction osteogenesis, DO * * Treatment of Ankylosis of Temporomandibular Joint Definition: intra-articular and extra-articular processes may restrict jaw motion severely. Ankylosis of the TMJ is an intra-articular process characterized by fibrous, fibro-osseous, or osseous obliteration(消失) of the joint space. Extracapsular causes of restricted jaw motion (pseudoankylosis) include but are not limited to coronoid-zygomatic fusion(融合), coronoid hypertropy, and muscular fibrosis. Indications for therapy for ankylosis (may include one or more of the following) Severely restricted jaw motion accompanied by one or more of the following: Inadequate masticatory function Abnormal speech Inability to undergo dental and /or medical care Compromised anesthetic management Inhibited facial growth Imaging evidence of osseous or soft tissue abnormality Presence of a general therapeutic goal B. Release of ankylosis C. Access for dental and/or medical care D. Improved speech E. Improved masticatory function F. Relief or reduction of pain Specific Therapeutic Goals for Ankylosis (The goal of therapy is to restore form and/or function. However, risk factors and potential complications may preclude(妨碍) complete restoration of form and/or function) Specific Factor Affecting Risk for Ankylosis (Severity factors that increase risk and the potential for known complications) Presence of a general factor effecting risk Type of ankylosis (ie, fibrous or bony) C. Etiology of the ankylosis (eg, traumatic or inflammatory) D. Extent and duration of ankylosis E. Degree of pre-existing muscular atrophy F. Ankylosis in a growing child Indicated therapeutic standards for ankylosis General history and physical examination Focused history and physical examination of the TMJ regionto region to determine the presence of indications for care of ankylosis and to identify factors affecting risks An imaging examination, if indicated, based on the history andphysical findings. The examination m